[analyte123]

It seems like you've been referring to "Hospital Services", which was 31% of all healthcare spending in 2023, and "Physician and Clinical Services", which was 20% of all healthcare spending in 2023, according to the CMS spreadsheet. But this is made up of revenue to the hospital or doctor's office, not just compensation for the medical professionals. These numbers include all the administration/dealing with insurance that has to be done at the hospital or physician office, as well as rent, malpractice insurance, drugs provided at the hospital, imaging costs and almost everything else that pays for capital spend, etc. The fees at the point of service basically have to account for all the bloat in the system, which of course includes some overdelivery and bloat inside the hospitals and clinics. But I really don't think this builds a case (like you seem to be doing) that doctors and nurses need to be squeezed in order to reduce US health care costs, especially when total healthcare expenditure has grown much faster than clinician pay over the past decades.

[tptacek]

I agree that the figure includes administration costs. CMS won't tell you that US physicians are paid 2x-3x more than they are in Europe, but OECD numbers will. CMS won't tell you about upcoding and overprescription, but the Dartmouth Atlas will. Meanwhile: the CMS picture will at least tell you that the majority of spending in our system is in on the provider side, and not in either prescription or insurance.

Again: I'm not out on a limb with these claims. I'm literally just remembering things Jonathan Gruber told Derek Thompson on a podcast, then looking up and bookmarking the numbers to confirm them. Many of the most popular message board narratives about healthcare disintegrate in the face of even these simple CMS numbers!